CRITTENDEN et al.
MCFADDEN, P. J., RAY and RICKMAN, JJ.
McFadden, Presiding Judge.
case involves a legal permanent resident's application
for Medicaid benefits. The commissioners of the Georgia
Department of Human Services and the Georgia Department of
Community Health appeal a superior court decision that Lissia
White is entitled to the benefits. The agencies argue that
the superior court erred by reversing the final agency
decision that White, a British citizen, had to be a legal
permanent resident for five years before she applied for
Medicaid in order to be eligible for Medicaid benefits. White
counters that federal law imposing a waiting period does not
apply to her because she entered the United States before
August 22, 1996 (the effective date of the legislation
establishing the waiting period) has been continuously
present in the United States since that time, and has
obtained qualified alien status. We agree with White that the
five-year waiting period does not apply to her. So we affirm
the superior court.
Facts and procedural posture.
The federal Medicaid program
provides subsidies to the states to furnish medical
assistance to "families with dependent children and of
aged, blind, or disabled individuals, whose income and
resources are insufficient to meet the costs of necessary
medical services." 42 USC § 1396-1. Although a
state's participation in the Medicaid program is
voluntary, a state that elects to join must administer a
state Medicaid plan that meets federal requirements.
Ga. Dept. of Behavioral Health & Developmental
Disabilities v. United Cerebral Palsy of Ga., 298 Ga.
779, 779-80 (1) (a) (784 S.E.2d 781) (2016) (citations
omitted). Appellant Georgia Department of Community Health is
the state agency responsible for administering Georgia's
Medicaid program. See 42 CFR § 431.10; see also OCGA
§ 49-4-142. The Division of Family and Children Services
of appellant Georgia Department of Human Services makes
Medicaid eligibility determinations. See OCGA § 49-4-3
(b). See generally Cook v. Glover, 295 Ga. 495, 497
(761 S.E.2d 267) (2014).
is a British citizen and a legal permanent resident of the
United States. She entered the United States in 1991. Her
immigration status at that time is not clear. In 1994, White
was issued a conditional green card that expired in 1996. In
2014, White was issued another green card that expires March
27, 2024. In 2016, White applied for Medicaid benefits.
caseworker with the Division of Family and Children Services
denied White's application for benefits on the ground
that she had not been a legal permanent resident of the
United States for five years. In making this determination,
the caseworker examined White's British passport, which
bore a stamp reading "Process for I-551 temporary
evidence of lawful permanent residence, " as well as a
stamp reading "NYC 12-13-94"; White's work
permit, which expired in 1996; and her current green card
which states "Resident since: 03/25/2014." The
caseworker also ran a report using the Systematic Alien
Verification for Entitlements ("SAVE") Program
through a database of the United States Department of
Homeland Security. According to the SAVE report, White's
"Date of Entry" was March 25, 2014, which is the
date of issuance of her current green card. White appealed
the decision to deny her application for benefits.
administrative law judge of the Office of State
Administrative Hearings affirmed the agency decision denying
benefits. White sought final agency review. The Commissioner
of the Department of Community Health, through an
administrative hearing officer, adopted the administrative
law judge's findings of fact and conclusions of law and
affirmed the decision to deny benefits.
then petitioned the superior court for judicial review. The
superior court reversed the final agency decision, finding
that the five-year waiting period does not apply to White
because she entered the United Suites before the federal
legislation's effective date. After we granted their
application for discretionary appeal, the agencies filed this
Standard of review.
the Georgia Administrative Procedure Act, OCGA § 50-13-1
et seq., a superior court "shall not substitute its
judgment for that of the agency as to the weight of the
evidence on questions of fact." OCGA § 50-13-19
(h). The superior court may reverse an agency decision only
substantial rights of the appellant have been prejudiced
because the administrative findings, inferences, conclusions,
or decisions are: (1) In violation of constitutional or
statutory provisions; (2) In excess of the statutory
authority of the agency; (3) Made upon unlawful procedure;
(4) Affected by other error of law; (5) Clearly erroneous in
view of the reliable, probative, and substantial evidence on
the whole record; or (6) ...